mother baby + peds Flashcards
1
Q
teratogenic drugs
A
TERA-TOWAS thalidomide epileptic meds (valproic acid, phenytoin) retinoid (vit a) ace inhibitors, ARBS third element (lithium) oral contraceptives warfarin alcohol sulfonamides & sulfones
2
Q
torch infections
A
infections that can cuase fetal abnormalities TORCH Toxoplasmosis parvOvirus-b19 (fifth disease) Rubella Cytomegalovirus Herpes simplex virus
3
Q
HELLP syndrome
A
variant of preeclampsia LIFE THREATENING COMPLICATION Hemolusis ELevated liver enzymes LP low platelet count
4
Q
magnesium sulfate
A
remember it acts like a depressant
therapeutic range: 4-7mg/dl
TOXICITY: RR <12 decr DTRs UOP <30 mL/hr EKG changes
ANTIDOTE: calcium gluconate
5
Q
methergine
A
action: vasoconstriction
- used to prevent or treat bleeding from the uterus after birth or abortion
contraindicated in people with HTN
6
Q
hemabate
A
prostaglandin. .. helps to control BP and muscle contractions (uterine contractions)
* *usually given btw 13 and 20th week**
CONTRAINDICATED in ppl with ASTHMA
7
Q
mispostol
A
given rectally
stimulates contraction of the uterine and smooth muscle
8
Q
what can a baby do at 5 months
A
grasp rattle
**Remember grasp something with 5 fingers, 5 months!
9
Q
what can a baby do at 12 months
A
- walks independently
- sits down from standing position without assistance
- feeds self finger-foods
- draws simple marks on paper
- turns pages in a book
- receptive language (understands common words independent of context… follows one-step gestured command)
- expressive language (first word… uses finger to point to things…imitates:gestures&vocal)
10
Q
signs of delay at 12 months
A
after independent walking for several months
- persistent tiptoe walking
- failure to develop a mature walking pattern
11
Q
signs of delay at 18 months
A
not walking
not speaking 15 words
does not understand the function of common household items
12
Q
toddler 18 months
A
- climbs stairs
- pulls toys
- stacking
- removes shoes and socks
- understands 200 words
- vocab = 15-20 words
13
Q
toddler 24 months
A
- right/left handed
- scribbles, paints, imitates strokes
- listens to simple stories
- “my” “mine”
- vocab 40-50 words, sentences 2-3 words
delay: cannot push a toy with wheels… or follow basic instructions
14
Q
4 years old
A
- uses scissors
- copies capital letters, draws circle, squares, traces a cross or diamond
- laces shoes
- uses language to engage in make-believe
- count a few numbers
- 1500 words
15
Q
5 years old
A
- skip, swim, skate, climb, swing
- use utencils
- mostly cares for own toileting needs
- count to 10
- speech gramatically correct
- 2000 words
16
Q
peds CPR <12 months
A
CARDIAC ARREST IN INFANTS IS USUALLY D/T RESP ETIOLOGY
- checks pulse no longer than 10 seconds
- call for help (activate EMS, delagate for someone to call 911/get AED)
- chest compressions
rate 100-120
** two fingers/two thumbs on sternum
**infant 1/3 chest, child 2 inch
single rescuer = 30:2
- continue until signs of help arrive or AED is available
17
Q
sensorimotor stage
A
age 0-2
- development thru 5 senses
- development thru motor response
- object permanence
- egocentric = only see the world from one’s own POV
18
Q
preoperational stage
A
2-7 years
- symbolic thinking
- imagination *magical, animism, plays pretend
- abstract thinking is difficult
- asks lots of questions
19
Q
concrete operational stage
A
7-11 years
- develop concrete cognitive operations sorting blocks in a certain order
- conservation is developed
- conductive reasoning
20
Q
formal operational stage
A
> 11
- rational, logical, organized, moral, consistent thinking
- hypothetical thinking
- abstract concepts *love, hate, failures, successes
- deductive reasoning
21
Q
variations in peds anatomy and physiology
A
- narrow airways
- nose breathers
- incr metabolic rate, incr O2 requirements
- incr risk for ear infections
- loses heat very easily d/t blood vessels closer to surface
- head and neck muscles are not well developed
- brain is highly vascular = incr risk for hemorrhage
- spine = very mobile = incr risk for cervical spine injury
- immature immune systems, limited exposure to disease
- myelinization is incomplete at birth… happens head to tail
- kidneys are larger in relation to abdomen… less protection… GFR slower
- incr risk for dehydration
22
Q
SIDS risk factors
A
- age 1-6 months
- preterm
- sleep position
- sibling death
- nicotine exposure
- socioeconomic status
- lack of prenatal care
- genetic
- bedding
- room temp… cooler = better
23
Q
education/prevention of SIDS
A
- sleep in supine position
- firm mattress… no toys, blankets, pillows, stuffed animals
- avoid overdressing infant
- no co-bedding
- normal room temp
- encourage pacifier use
24
Q
bronchiolitis (RSV)
initial vs continued symptoms
A
- very contagious, viral illness… starts as URI and moves into chest
initial - upper resp symp (nasal congestion, runny nose, cough, sneezing)
- fever
continued - lower resp symp (tachypnea, cough, wheezing)
25
emergent bronchiolitis s/s
- grunting
- nasal flaring
- cyanosis
- hypoxia
- resp failure
- apneic episodes
26
tx of bronchiolitis
- airway maintenance (o2, suctioning, position at 30-40 degree angle)
- hydration
- contact and standard precautions
- hosp only if severe
27
reyes syndrome
rare disease affecting young children recovering from viral illness (flu or chx pox)
- triggered d/t taking aspirin, alka seltzer, pepto-bismol, kaopectate
s/s
- encephalopathy/cerebral edema
- acute fatty liver failure (incr liver enzymes, incr AST + ALT)
```
CHILDS
Confusion
Hyperreflexia
Irritability
Lethargy
Diarrhea and vomitting
Seizures
```
28
intussusception
ileum telescopes into the cecum --> obstruction = pain --> compression of blood vessels --> blood flow decr --> bowel ischemia --> rectal bleeding (currant jelly stools)
s/s
- intermittent pain and cramping
- draws up legs toward abdomen in severe pain while crying
- diarrhea and vomitting
- currant jelly stools
- lethargy
- sausage shaped mass
29
tx for intussusception
- IV fluids
- antibiotics
- decompression via NG
- monitor for signs of perforation and shock
- air or barium enema **
30
pyloric stenosis s/s and tx
```
s/s
- projectile vomiting
- non-bilious emesis
- olive shape mass palpable in RUQ
- hungry despite reg feeds
- weight loss
- dehydration (incr hematocrit and BUN)
- LEADS TO METABOLIC ALKOLOSIS
TX
- monitor I/Os, signs of dehydration
- daily weights
- pyloromyotomy
```
31
epiglotitis cause/s&s/tx
```
- caused by hib + steptococcus pneumonia
s/s
- tripod position
- drooling/dysphagia
- retractions, nasal flaring
- stridor
- high fever, sore throat, tachy
TX
- never leave client, assess O2 status, IV access, calm environment, NPO, do not put in supine position
- meds
** antibiotics, antipyretics, corticosteriods, iv fluids
```
DO NOT PUT TONGUE BLADE IN MOUTH, NO ORAL TEMPS OR THROAT CULTURE
32
resp condition *like croup* indicating you need to seek help
PT IN RESP DISTRESS
- child is confused/restless
- blue lips/nails
- incr resp rate
- retractions
- nasal flaring
- drooling/can't swallow
33
causes and s/s of croup
causes: parainfluenza virus... leads to inflamation of larynx, trachea and bronchi
```
s/s
inflammation and edema obstruct airway
stridor
subglottic swelling (hoarseness in voice)
seal bark cough
```
34
fever management of kid
```
antipyretics (ibuprofen)
s/s of dehydration and electrolyte imbalances
sponge bath
remove excess clothing to decr temp
cool compress on forehead
```
35
febrile seizure risk factors, s/s and tx
seizures associated with a fever **NOT R/T intracranial infection, metabolic imbalance, viral illness**
```
s/s
rapid incr in core temp, child may be drowsy in postictal period
risk factors
6 months-5 yrs
rapidly developing, HIGH fever
family hx
certain vaccines = DTP and MMR
tx
NOT anticonvulsant therapy
rectal diazepam
educate parents to seek help if >5 mins + repeat
```
36
CF patho and diagnosis
- excrine gland disorder w incr production of thick mucus
- autosomal recessive
- leads to mucous plugging
diagnosis
- ambry test
- positive sweat sodium chloride test
- genetic screen
37
tx of CF
PANCREATIC ENZYMES
- chest PT... not done right after meals... helps to break up mucus and strengthen resp muscles
- nebulizers
- prevent GI blockage w fluids and stool softeners
- incr protein, fat, calories, fat soluble vitamins
38
scarlet fever s/s
complication of group A streptococcal infection
- transmitted via droplets and resp tract secretions
S/S
- onset = abrupt
- red rash --> sandpaper like rash *not usually seen on palms and soles of feet*
- pharyngitis
- fever, body aches, chills
- strawberry tongue
- tender cervical nodes
- tonsils red
- exudate present
39
complications + tx of scarlet fever
```
complications
- rhematic fever
- glomerulonephritis
- abscesses of throat
- pneumonia
TX
- antibiotics *penicillin v* *erythromycin for those allergic*
- fluids and soft foods
- comfort
- cool mist humidifier
```
